Adequacy of Depression Treatment in Spouses of Cancer Survivors: Findings From a Nationally Representative US Survey

Background Recent research suggests that mental health problems in spouses of cancer survivors are associated with worse mental health in the survivors themselves. Adequately treating spousal mental health problems therefore represents an opportunity to improve outcomes for both cancer survivors and their co-surviving family members. Objective Using nationally representative data, this study sought to determine how depression treatment differs between spouses of cancer survivors with depression compared to the general married population and assess rural/urban disparities in treatment. Design The design of the study is cross sectional. Participants Data are from the Medical Expenditures Panel Survey, a household-based survey of US adults; we concatenated data from 2004 to 2013. We identified spouses of cancer survivors (n = 225) and a comparison group of married adults (n = 3678). Main Measures Key measures included depression, guideline concordance of depression treatment (at least four prescriptions related to depression treatment, or at least eight psychotherapy or counseling visits), and sociodemographic characteristics. Logistic regressions evaluated the association between whether their spouse had cancer and receipt of guideline-concordant treatment, controlling for sociodemographic characteristics; secondary analyses included rurality as a moderator. Analyses were weighted to account for the complex sampling design. Key Results Spouses of cancer survivors were 33% less likely to receive guideline-concordant depression treatment than comparison spouses (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.45–0.99), controlling for covariates. Rural-urban disparities were observed: rural spouses of cancer survivors were 72% less likely to receive guideline-concordant treatment (OR 0.28, 95% CI 0.11–0.68) than rural comparison spouses. Spouses of cancer survivors and comparison spouses were no different in their receipt of any treatment versus no treatment. Conclusions Spouses of cancer survivors with depression may be at increased risk of non-guideline-concordant depression treatment, particularly in rural areas. The findings have implications for identifying and educating individuals with depression in primary care and other clinical areas

Social Security: The Government Pension Offset (GPO)

Social Security spousal benefits were established in the 1930s to help support wives who are financially dependent on their husbands. It has since become more common for both spouses in a couple to work, with the result that, in more cases, both members of a couple are entitled to Social Security or other government pensions based on their own work records. Social Security generally does not provide both a full retired-worker and a full spousal benefit to the same individual. Two provisions are designed to reduce the Social Security spousal benefits of individuals who are not financially dependent on their spouses because they receive benefits based on their own work records. These are • the “dual entitlement” rule, which applies to spouses who qualify for both (1) Social Security spousal benefits based on their spouses’ work histories in Social Security-covered employment and (2) their own Social Security retired or disabled worker benefits, based on their own work histories in Social Securitycovered employment; and • the GPO, which applies to spouses who qualify for both (1) Social Security spousal benefits based on their spouses’ work histories in Social Security-covered employment and (2) their own government pensions, based on their own work in government employment that was not covered by Social Security. The GPO reduces Social Security spousal benefits by two-thirds of the pension from non-covered government employment. The GPO does not reduce the benefits of the spouse who was covered by Social Security. Opponents contend that the GPO provision is basically imprecise and can be unfair. Defenders argue it is the best method currently available for preserving the spousal benefit’s original intent of supporting financially dependent spouses, and also for eliminating an unfair advantage for spouses working in non-Social Security-covered employment compared with spouses working in Social Security-covered jobs (who are subject to the dual entitlement rule)

Is humn mating adventitious or the result of lawful choice? A twin study of mate selection.

Inventory data on a large sample of middle-aged twins and their spouses confirmed that spousal pairs are consistently but weakly similar on traits of personality, interests, talents, and attitudes. We argue, however, that neither the Similarity model of mate selection, nor one of its facets, the Equity model, can account for specific mate choice. We therefore tested the hypothesis that people select their mates using idiosyncratic criteria and that the spouses of monozygotic (MZ) twins should therefore be very similar. When compared to spouses of dizygotic (DZ) twins or even to random pairs of spouses, the spouses of MZ twins failed to show the predicted excess of small intra-spouse differences. We asked 547 of these twins to rate their attitudes toward their cotwin's choices of wardrobe, furnishings, vacations, jobs - and spouses; a similar questionnaire was completed by the spouses of these twins. Both data sets confirm that MZ twins are very similar in most of their choices, more so than DZ twins, but nearly 40% of both MZs and DZs recall that they actually disliked their cotwin's choice of mate at the time that choice was made. Similarly, 30% of the spouses of MZ twins report actually disliking the identical twin of the mate they had recently selected. Our findings suggest that characteristics both of the chooser and the chosen constrain mate selection only weakly. We propose that it is romantic infatuation that commonly determines the final choice from a broad field of potential eligibles and that this phenomenon is inherently random, in the same sense as is imprinting in precocial birds

Synchronous Leisure, Jointness and Household Labor Supply

This paper examines the synchronous leisure of spouses and the extent to which spouses spend time together. The time budget data set used in this paper allows for a distinction between simultaneous time-use of spouses and the actual time that spouses meet. A comparison between couples and matched singles suggests that only about 12 percent (45 minutes per day) of the synchronous leisure is caused by active synchronization. Spouses’ decisions about market work and leisure timing are very interdependent during most hours of the day. The results also suggest that, conditional on synchronous leisure, parents with high incomes spend more time together than others, while more educated people allocating less time to their spouses.Time-use; synchronous leisure; working hours; togetherness; family economics; statistical matching

How Do Female Spouses’ Political Interests Affect Male Spouses’ Views About a Women’s Issue?

This paper explored how the degree of female spouses’ political interest affects male spouses’ views about women’s empowerment, using individual level data in Japan. Controlling for unobserved area-specific fixed effects, results showed that males were likely to consider women’s empowerment important if their spouses were interested in politics. This spouse effect was observed for conservative males but not for progressive-neutral males. Results were unchanged when the endogeneity bias caused by spouses’ political interests were controlled for. These findings suggest that female family members’ political interests and views play an important role in determining male views regarding women’s issues.Spouse, political opinion, women’s empowerment

Unemployment Compensation (Insurance) and Military Service

The Unemployment Compensation (UC) program contains several provisions relevant to current and former military service personnel and their families. The UC program does not provide benefits for military servicemembers on active duty. However, former active duty military personnel (and certain reservists) separated from active duty may be eligible for Unemployment Compensation for Ex-Servicemembers (UCX). Spouses of military service personnel who voluntarily quit a job to accompany their spouses on account of a military transfer may be eligible for UC benefits, based on the laws of the state where the civilian spouse was employed. Military service of business owners, employees, and employees’ spouses may impact the state unemployment tax rate that certain employers face. States may choose to create provisions that remove or limit these tax increases in certain situations

Unemployment Compensation (Insurance) and Military Service

[From Summary] The Unemployment Compensation (UC) program contains several provisions relevant to current and former military service personnel and their families. The UC program does not provide benefits for military servicemembers on active duty. However, former active duty military personnel (and certain reservists) separated from active duty may be eligible for Unemployment Compensation for Ex-Servicemembers (UCX). Spouses of military service personnel who voluntarily quit a job to accompany their spouses on account of a military transfer may be eligible for UC benefits, based on the laws of the state where the civilian spouse was employed. Military service of business owners, employees, and employees\u27 spouses may impact the state unemployment tax rate that certain employers face. States may choose to create provisions that remove or limit these tax increases in certain situations. This report will be updated as events warrant

Allocating Time: Individuals' Technologies, Household Technology, Perfect Substitutes, and Specialization

In an efficient household if the spouses' time inputs are perfect substitutes, then spouses will “specialize" regardless of their preferences and the governance structure. That is, both spouses will not allocate time to both household production and the market sector. The perfect substitutes assumption implies that spouses' "unilateral" production functions (i.e., the household production function when only one spouse allocates time to home production) are closely related, satisfying a highly restrictive condition that I call "compatibility." I introduce the “correspondence assumption,” which postulates that the unilateral production functions in a newly formed household coincide with individuals’ production functions before they enter marriage. The correspondence assumption provides a plausible account of the genesis of household technology and simplifies its estimation. I introduce the "additivity assumption” which postulates that the household production function is the sum of the spouses' unilateral production functions and argue that additivity is implicit in much of the new home economics. Together, the correspondence and additivity assumptions imply that individuals’ technologies reveal the entire household technology. I show that perfect substitutes, additivity and concavity imply that the household production function is of the same form as the unilateral production functions, exhibits constant returns to scale, and depends on the spouses' total time inputs, measured in efficiency units.

Examining a Ripple Effect: Do Spouses’ Behavior Changes Predict Each Other’s Weight Loss?

Background. Including spouses in obesity treatment has been found to promote weight loss. We assessed whether spouses’ diet and activity changes impacted each other’s weight loss when both members attended an active weight loss program (TOGETHER) or only the primary participant attended treatment (ALONE). Methods. Heterosexual couples () enrolled in an 18-month randomized controlled weight loss trial were weighed and completed measures of dietary intake and physical activity at baseline and 6 months. We conducted dyadic data analyses using the Actor-Partner Interdependence Model. Results. Participants’ weight loss was not predicted by their partners’ behavior changes. However, partners’ weight loss was predicted by their participants’ changes in calorie and fat intake. When partners were coupled with a participant who did not reduce their own calorie and fat intake as much, these partners had higher weight loss when treated in the TOGETHER group but lower weight loss when they were untreated in the ALONE group. There were no reciprocal effects found with physical activity changes. Conclusions. Direct treatment had the greatest impact on participants and partners who were treated. Untreated partners’ weight losses were positively impacted by their spouses’ dietary changes, suggesting a ripple effect from treated spouses to their untreated partners

Ethnic Identification, Intermarriage, and Unmeasured Progress by Mexican Americans

Using Census and CPS data, we show that U.S.-born Mexican Americans who marry non- Mexicans are substantially more educated and English proficient, on average, than are Mexican Americans who marry co-ethnics (whether they be Mexican Americans or Mexican immigrants). In addition, the non-Mexican spouses of intermarried Mexican Americans possess relatively high levels of schooling and English proficiency, compared to the spouses of endogamously married Mexican Americans. The human capital selectivity of Mexican intermarriage generates corresponding differences in the employment and earnings of Mexican Americans and their spouses. Moreover, the children of intermarried Mexican Americans are much less likely to be identified as Mexican than are the children of endogamous Mexican marriages. These forces combine to produce strong negative correlations between the education, English proficiency, employment, and earnings of Mexican-American parents and the chances that their children retain a Mexican ethnicity. Such findings raise the possibility that selective ethnic “attrition” might bias observed measures of intergenerational progress for Mexican Americans